WASHINGTON — If obesity rates continue on their current trajectories, by 2030, 13 states may have adult obesity rates above 60%, 39 states may have rates above 50%, and all 50 states may have rates above 44%, according to “F as in Fat: How Obesity Threatens America’s Future 2012.” It is the first time the report has provided analysis on future obesity rates.

“This study shows us two futures for America’s health,” said Risa Lavizzo-Mourey, president and chief executive officer of the Robert Wood Johnson Foundation. “At every level of government, we must pursue policies that preserve health, prevent disease and reduce health care costs. Nothing less is acceptable.”

During 2011, the rate of adult obesity exceeded 25% in 39 states, the third year in a row it has exceeded 25% in at least 38 states. The rate of obesity for the second year in a row exceeded 30% in 12 states in 2011. As recently as 1991, no state had an obesity rate of more than 20%. In 1980, the national average of obese adults was 15%.

For adult obesity rates, Mississippi once again fared the worst, at 34.9%, the eighth consecutive year it has topped the list and up from 34.4% in 2010. Other states exceeding the 30% rate were Louisiana (33.4%), West Virginia (32.4%), Alabama (32%), Michigan (31.3%), Oklahoma (31.1%), Arkansas (30.9%), Indiana (30.8%), South Carolina (30.8%), Kentucky (30.4%), Texas (30.4%), and Missouri (30.3%).
Colorado once again was the best, coming in at 20.7%, but the rate was up from 19.8% in 2010, when Colorado was the only state with a rate below 20%.

In providing forecasts to 2030, the study uncovered some alarming findings. Calculating projections using a model published in The Lancet in 2011 and data from the Behavioral Risk Factor Surveillance System, which is an annual phone survey conducted by the Centers for Disease Control and Prevention and state health departments, researchers determined Mississippi’s adult obesity rate will total 66.7% in 2030, followed by Oklahoma at 66.4% and Delaware at 64.7%. The District of Columbia is forecast to have the lowest rate at 32.6%, while Colorado’s rate will have climbed to 44.8%.

The report also examined projected increases in disease rates and costs for health care.

“If states’ obesity rates continue on their current trajectories, the number of new cases of type 2 diabetes, coronary heart disease and stroke, hypertension and arthritis could increase 10 times between 2010 and 2020 — and double again by 2030,” researchers said. “Obesity could contribute to more than 6 million cases of type 2 diabetes, 5 million cases of coronary heart disease and stroke, and more than 400,000 cases of cancer in the next two decades.”

In terms of medical costs, researchers said that by 2030 those costs associated with treating preventable obesity-related diseases are estimated to increase by $48 billion to $66 billion per year in the United States, and the loss in economic productivity may be between $390 billion and $580 billion annually by 2030.

Researchers did note if states could reduce the average body mass index (B.M.I.) of residents by 5% by 2030, than no state would have an obesity rate above 60% and more than 100 cases of obesity-related cancer per 100,000 people could be prevented in all states. And nearly every state could save between 6.5% and 7.9% in health care costs, the report said.

“We know a lot more about how to prevent obesity than we did 10 years ago,” said Jeff Levi, Ph.D., executive director of Trust for America’s Health. “This report outlines how policies like increasing physical activity time in schools and making fresh fruits and vegetables more affordable can help make healthier choices easier. Small changes can add up to a big difference. Policy changes can help make healthier choices easier for Americans in their daily lives.”